Early outcomes following isolated coronary artery bypass surgery: Influence of peripheral artery disease

Abstract

Background: We carried out a propensity score-based analysis on early outcomes after coronary artery bypass grafting (CABG) in patients with and without peripheral artery disease (PAD).

Materials and methods: A total of 11 311 patients undergoing isolated CABG between 1997 and 2017 were included in the study. Patients were divided into two groups based on whether they were affected (n = 1961) or not affected (n = 9350) by PAD. Inverse probability of treatment weighting was employed to reduce confounding preoperative and operative variables. The main endpoints were death, cardiac death, stroke, and limb ischemia requiring percutaneous or surgical revascularization.

Results: The excellent balance was obtained, and the groups were very similar. For death and cardiac death, there were no differences between patients with and without PAD (P = .06 and P = .179, respectively). In contrast, PAD patients showed a higher incidence of stroke (P = .04), acute kidney disease (AKD) (P = .003) and limb ischemia requiring intervention (P < .001) than patients without PAD.

Conclusions: The presence of peripheral arterial disease increases the incidence of postoperative stroke, AKD and limb ischemia requiring intervention, independent of patient characteristics, concomitant risk factors, surgical approaches, and techniques. Further larger studies are necessary to confirm our findings.

Keywords: coronary artery bypass; peripheral arterial disease; peripheral vascular disease.